End-of-life care in elderly persons is a critical aspect of healthcare that focuses on ensuring comfort, dignity, and quality of life during the final stages. The principles of end-of-life care are grounded in compassion, respect for autonomy, and individualized support that addresses the physical, emotional, social, and spiritual needs of older adults. One of the fundamental principles is patient-centered care, which emphasizes listening to the preferences and values of the elderly person. This includes understanding their wishes regarding medical interventions, pain management, and the setting in which they wish to spend their final days. Respecting autonomy is crucial, as elderly individuals should have the right to make informed decisions about their care, including the choice to refuse aggressive treatments that may not enhance their quality of life. Another principle is beneficence, which involves healthcare providers acting in the best interest of the patient by alleviating suffering and ensuring comfort through appropriate interventions. This is closely linked with non-maleficence, the ethical duty to avoid causing harm, which in end-of-life care often means avoiding unnecessary or burdensome procedures that may increase pain or distress. Holistic assessment is a key element of effective end-of-life care for older adults. Comprehensive evaluation involves not only the medical condition and prognosis but also the psychological, social, and spiritual needs of the patient. Pain and symptom management are central components of this assessment, as uncontrolled pain can significantly reduce quality of life. Palliative care practices emphasize early identification and treatment of pain, dyspnea, nausea, anxiety, depression, and other distressing symptoms. The goal is to provide comfort and relieve suffering rather than to prolong life at all